The present invention is directed to the field of surgery. Specifically, the invention is directed to instruments and methods for cutting and shaping bone. The invention is particularly advantageous for cutting and shaping bone for use in bone grafting.
Bone grafts are used in many types of bone surgery. Often times, bone used as a bone graft has been prepared according to generic size and shape specifications. However, preparing a bone graft during surgery can provide precisely configured bone at significantly reduced costs. Having instruments for sizing or shaping bone in the operating room can enhance the overall success of the surgical procedure by enabling the surgeon to fine tune the configuration of the graft for a particular site.
Accordingly, there is a need for instruments and methods to size and shape bone for a particular application. The present invention is directed to this need.
The present invention is directed to guides and methods for cutting or shaping bone. A guide (or jig) provides for maintaining a selected positional relationship between herein disclosed cutting or shaping instruments and bone that can be held by the jig. The guide can be configured and sized for placement on a surgery table, instrument table or similar structure for use in an operating room. In preferred embodiments, the jig is portable and manufactured from a material such as stainless steel (or other materials suitable for surgical use) which permits sanitization or sterilization using known procedures. The jigs provide real time preparation of a bone graft from heterologous, homologous, or autologous sources (i.e., xenograph, allograft, autograft).
Throughout the specification, guidance may be provided through lists of examples. In each instance, the recited list serves only as a representative group. It is not meant, however, that the list is exclusive.
Unlike many prior systems, the invention provides the surgeon with the flexibility to cut and shape a bone graft to any size or shape needed at the time of surgery. In some embodiments, the guides disclosed include a surface for cooperative fit with an inanimate object in the operating room. If necessary, the guides can be stabilized during use by one or more c-clamps or a similar fixating device or by a surgical assistant or other person holding the guide in a stable position during graft preparation.
The guides of the invention are suitable for use with any type of bone that is used for grafting in any location. In some embodiments, the guides are particularly advantageous for use in spinal surgery applications. Examples of bones which can be used for spinal applications include, without limitation, femur, tibia, patella and fibula. In the case of vertebral fusion procedures (e.g., intradiscal graft implant), femoral and tibial bone can typically be used as grafts for fusion of lumbar and thoracic vertebrae and fibular bone for cervical vertebrae.
In one embodiment, a guide according to the invention can include a base, bone holding arrangement, bone cutting arrangement having at least one cutting guide and a bone shaping arrangement. The bone holding arrangement can include a first and second bone holding member. A bone holding member typically includes a gripping end for contacting the bone. The gripping end can have any of various surface contours to facilitate secure engagement of the bone.
In an alternative embodiment, the bone cutting guide can include a base, a bone holding arrangement and a bone cutting arrangement including a first cutting block and a second cutting block. Each of the first and second cutting blocks can include a slot for passing a saw blade therethrough for cutting bone.
In another embodiment, a guide according to the invention can include a base, a bone holding arrangement and a bone cutting arrangement wherein the bone cutting arrangement includes at least one cutting guide. The cutting guide can include a slot for passing a saw therethrough and is arranged such that when bone is fixed in a first position by the bone holding arrangement, a saw passed through the slot in the first cutting guide can make a first cut in the bone at a first location. The cutting guide can then be repositioned and a second cut made with the saw at a second location in the bone.
The invention also provides methods for bone cutting and shaping.